Individual
KIMBERLY ANNE KELLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NNP
Contact information
Practice address
615 S NEW BALLAS RD, SAINT LOUIS, MO 63141-8221
(314) 251-6450
Mailing address
2068 BELLTOWER DR, SAINT PETERS, MO 63376-7200
(636) 866-6144
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
2013024201
MO
363LN0000X
Neonatal Nurse Practitioner
Primary
104406946
MO
Other
Enumeration date
07/25/2019
Last updated
08/04/2020
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